BLS and PRAPID

Question 1

Why are Children at higher risk of airway obstruction?

Answer 1

Obligate nasal breathers until 6/12
Tongue proportionally big to mouth
Short neck

Question 2

Responding to airway compromise

Answer 2

Older= Head tilt and chin lift +/- Jaw thrust
<1 year= Neutral position +/- Jaw thrust

OPA or NPA

Question 3

What pathology is a CI to an airway adjunct?

Answer 3

Basal Skull Fracture

Question 4

RR of an infant

Answer 4

30-40

Question 5

RR of 5-12 year olds

Answer 5

20-25

Question 6

What positions suggest cerebral compromise

Answer 6

Decorticate or Deceberate

Question 7

How do you quickly assess dehydration?

Answer 7

Fontanelle
CRT
Eyes
Mucous Membranes

Question 8

Fluid bolus given in an acutely shocked child?

Answer 8

20mls/kg/hr 0.9% NaCl

Assess response +/- 2nd bolus

Question 9

Cushing’s response indicating raised ICP

Answer 9

Bradycardia
HTN
Tachypnoea

Question 10

When would you treat hypoglycaemia?

Answer 10

Blood glucose <4mmol/L

Treat with 2-3mg 10% Glucose

Question 11

Likely cause of cardiac arrest in children

Answer 11

Hypoxia

Question 12

3 S’s of BLS

Answer 12

Safety
Stimulate
Shout for Help

Question 13

Interventions in BLS

Answer 13

Open Airway
5 Rescue breaths each 1s long
15:2 chest compressions especially if HR<60
Help

Question 14

Ratio of chest compressions to breaths

Answer 14

15:2

Do 3:1 in newborn

Question 15

Agonal breathing

Answer 15

Irregular gasping few minutes post-cardiac arrest therefore…
5 RB then 15:2

Question 16

Management of choking with an ineffective cough

Answer 16

If unconscious then open airway do 5 breaths and start CPR

If conscious then 5 back blows, 5 thrusts

Single finger sweep allowed

HEAD DOWN

Question 17

Back blows and thrust location in different ages

Answer 17

> 1 year then do abdo

<1 year then do chest

Question 18

Management of choking with effective cough

Answer 18

Encourage cough

Check for deterioration to ineffective cough

Question 19

Ineffective vs Effective cough

Answer 19

Ineffective- Cannot vocalise, quiet and silent

Effective- Crying, verbal response, able to take breath before coughing

Question 20

Anaphylaxis

Answer 20

IgE mediated T1 HSN reaction
Increased bronchial secretions and SM tone
Increased capillary permeability
Decreased Vascular SM tone

Question 21

Dose of adrenaline in Anaphylaxis

Answer 21

1: 1000 0.5ml if 12+ IM in thigh
0. 3ml if 6-12 and 0.15 if <6

Can repeat after 5 mins

Question 22

What PAWS score indicates need for Urgent review

Answer 22

> 10

6-9 is hourly obs and Dr review

Question 23

Management of Status Epilepticus

Answer 23

1) Iv lorazepam 0.1mg/kg ir 0.5mg/kg Bucc Mid or Rec Diaz

Repeat after 10 mins max 2 doses

2) Start this step 20 mins after start IV phenytoin 20mg/kg IV over 20 mins (Alt= Phenobarbital)
3) RSI with thiopentone

Question 24

Clinical dehydration vs shock vs late decompensated shock

Answer 24

Clinical dehydration= HR/RR inc, Decreased skin turgor, Decreased UO

Shock= Above + Pale, Cold, Prolonged CRT, Consciousness decreased

Decompensated= Hypotension, Bradycardia, Kussmal breathing, Blue, No UO

Question 25

4 types of shock

Answer 25

Hypovolaemic
Distributive
Cardiogenic
Obstructive

Question 26

Obstructive shock

Answer 26

Tension Pneumothorax

Cardiac Tamponade

Question 27

Causes of distributive shock

Answer 27

Anaphylaxis

Brain injury

Question 28

Hypovolaemic shock

Answer 28

Gastroenteritis, DKA, Bowel obstruction, Haemorrhage

Question 29

What HR is a typical indicating for chest compressions during BLS

Answer 29

<60bpm